CMS approved MS SPA 21-0007 APR-DRG on September 23, 2021. State Plan Amendment (SPA) 21-0007 All Patient Refined-Diagnosis Related Groups (APR-DRG) Reimbursement was submitted to update the following hospital inpatient services effective July 1, 2021: 1) Update APR-DRG parameters, 2) use cost-to-charge (CCRs) ratios in effect July 1, 2021 to calculate outlier payments for claims with last dates of service on or after July 1, 2021, and 3) remove language that intensive outpatient programs and partial hospitalization programs are not covered in the outpatient hospital setting.
For more information read the approved SPA pages.
September 28, 2021
